Correlations among Persistent Viral Infection,Heart Function and Chinese Medicine Syndromes in Dilated Cardiomyopathy Patients

Objective：To investigate the correlations among persistent viral infection,heart function and Chinese medicine（CM） difined-syndromes in patients with dilated cardiomyopathy（DCM）.Methods：Fifty patients with DCM in the First Affiliated Hospital of Zhejiang Chinese Medical University from October 2009 to December 2011 were selected as the research subjects,and 30 healthy people were simultaneously selected as the normal control group to detect persistent viral infections after admission.The CM syndrome type and grade of heart function were then evaluated.The expression level of Coxsackie adenovirus receptor（CAR） was detected using the flow cytometry（FCM） technique,coxsackie virus RNA（CVB-RNA） using reverse transcription polymerase chain reaction（RTPCR）,and the plasma brain natriuretic peptide（BNP） level with a Triage meter plus diagnosis instrument.Finally,the parameters such as left ventricular end diastolic diameter（LVEDd） and left ventricular ejection fraction（LVEF） were measured by ultrasonic cardiogram.Person correlation analysis was used for measured data,Spearman correlation analysis for rating data,and the Chi-square test for numerical data.Results：CVB-RNA was positive in 22 patients（44%） with DCM,while only 6 cases（20%） were CVB-RNA-positive in the normal control group,with a significant difference between the two groups（P〈0.01）.The expression level of CAR was significantly elevated in the DCM group compared with the normal control group（P〈0.01）.In CVB-RNA-positive patients（22 cases）,the expression level of CAR was significantly higher than in CVB-RNA-negative patients（28 cases;P〈0.01）.In the DCM patients,there was a positive correlation between the CAR expression and the BNP level（r=0.34,P〈0.05）,while no significant difference was found between the CAR expression and the LVEF and LVEDd（r=-0.32,0.30,P〉0.05）.There was no clear correlation between virus infection and the CM syndrome types in DCM patients（r=-0.22,P〉0.05）.According to the sequence of syndrome types：phlegm → qi deficiency → blood stasis → hydroretention with asthenic yang（from low to high）,a positive correlation was existed between the BNP levels and CM syndrome types（r=0.139,P〈0.05）.Conclusion：The expression of CAR on the surface of white cells could be used to detect persistent viral infection.The expression level of CAR and heart function in DCM patients were highly correlated.The expression level of BNP may serve as an objective index for differentiating CM syndromes for patients with DCM.

Thinking on Treatment of Post-reperfusion Events in Patients with Coronary Heart Disease by Integrated Traditional Chinese and Western Medicine

In the 1970＇s, promoting blood circulation to remove blood stasis （PCRS） was the main method in integrative traditional Chinese and Western medicine （ICWM） in treating acute myocardial infarction （AMI）. It decreased the case fatality rate of AMI from 30% to 13%-16% as compared with that treated by simple Western internal medical conservative treatment. Later in the 1980＇s, such therapeutic approaches as infarction related arterial revascularization, thrombolysis and percutaneous coronary intervention （PCI） became the most effective means in treating AMI, which could re-canalize the obstructed coronary vessels, recover the blood perfusion of myocardium, and thus to save the ischemic myocardium, diminute the infarcted size, preserve the ventricular function and improve the patient＇s near and long-term prognosis, with the fatality rate reduced by 5%-7%. Hence, the some-time superiority of ICWM in treating AMI was overshadowed with no more luster left.

Medicine for a Broken Heart

I am a nineteen-year-old American girl studying at Carnegie Mellon University.Having lived very closely with othgr women in the housing dorms, I am very

Metabolomic Profiling Reveals Distinct Patterns of Tricarboxylic Acid Disorders in Blood Stasis Syndrome Associated with Coronary Heart Disease

Objective： To investigate the underlying metabolomic profiling of coronary heart disease（CHD） with blood stasis syndrome（BSS）. Methods： CHD model was induced by a nameroid constrictor in Chinese miniature swine. Fifteen miniature swine were randomly divided into a model group（n=9） and a control group（n=6）, respectively according to arandom number table. After 4 weeks, plasma hemorheology was detected by automatic hemorheological analyzer, indices including hematocrit, plasma viscosity, blood viscosity, rigidity index and erythrocyte sedimentation rate; cardiac function was assessed by echocardiograph to detect left ventricular end-systolic diameter（LVED）, left ventricular end-diastolic diameter（LVEDd）, ejection fraction（EF）, fractional shortening（FS） and other indicators. Gas chromatography coupled with mass spectrometry（GC-MS） and bioinformatics were applied to analyze spectra of CHD plasma with BSS. Results： The results of hemorheology analysis showed significant changes in viscosity, with low shear whole blood viscosity being lower and plasma viscosity higher in the model group compared with the control group. Moreover, whole blood reduction viscosity at high shear rate and whole blood reduction viscosity at low shear rate increased significantly（P〈0.05）. The echocardiograph results demonstrated that cardiac EF and FS showed significant difference（P〈0.05）, with EF values being decreased to 50% or less. The GC-MS data showed that principal component analysis can clearly separate the animals with BSS from those in the control group. The enriched Kyoto Encyclopedia of Genes and Genomes biological pathways results suggested that the patterns involved were associated with dysfunction of energy metabolism including glucose and lipid disorders, especially in glycolysis/gluconeogenesis, galactose metabolism and adenosine-triphosphate-binding cassette transporters. Conclusion： Glucose metabolism and lipid metabolism disorders were the major contributors to the syndrome classification of CHD with BSS.

Cardioprotective Effects of Qishen Granule(芪参颗粒)on Sarcoplasmic Reticulum Ca^2＋ Handling in Heart Failure Rats

Objective：To assess the effects of Qishen Granule（芪参颗粒, QSG） on sarcoplasmic reticulum（SR） Ca^2＋ handling in heart failure（HF） model of rats and to explore the underlying molecular mechanisms. Methods：HF rat models were induced by left anterior descending coronary artery ligation surgery and high-fat diet feeding. Rats were randomly divided into sham（n=10）, model（n=10）, QSG（n=12, 2.2 g/kg daily） and metoprolol groups（n=12, 10.5 mg/kg daily）. The therapeutic effects of QSG were evaluated by echocardiography and blood lipid testing. Intracellular Ca^2＋ concentration and sarco-endoplasmic reticulum ATPase 2a（SERCA2a） activity were detected by specific assay kits. Expressions of the critical regulators in SR Ca^2＋ handling were evaluated by Western blot and real-time quantitative polymerase chain reaction. Results：HF model of rats developed ventricular remodeling accompanied with calcium overload and defective Ca^2＋ releaseuptake cycling in cardiomyocytes. Treatment with QSG improved contractive function, attenuated ventricular remodeling and reduced the basal intracellular Ca^2＋ level. QSG prevented defective Ca^2＋ leak by attenuating hyperphosphorylation of ryanodine receptor 2, inhibiting expression of protein kinase A and up-regulating transcriptional expression of protein phosphatase 1. QSG also restored Ca^2＋ uptake by up-regulating expression and activity of SERCA2 a and promoting phosphorylation of phospholamban. Conclusion：QSG restored SR Ca^2＋cycling in HF rats and served as an ideal alternative drug for treating HF.

Relationship between Two Blood Stasis Syndromes and Inflammatory Factors in Patients with Acute Coronary Syndrome

Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients with acute coronary syndrome（ACS）. Methods： Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups： 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1（ICAM-1）, chitinase-3-like protein 1（YKL-40） and lipoprotein-associated phospholipase A2（Lp-PLA2）. Results： Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference（P〉0.05）; ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS（P〈0.05）. Conclusion： Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.